DOI: https://doi.org/10.22263/2312-4156.2023.3.79
A.V. Sidarenka
Determination of prognostic duration of bronchial asthma remission after allergen-specific immunotherapy
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2023;22(3):79-85.
Abstract.
Objectives. To evaluate, using ROC analysis, the duration of post-immunotherapeutic remission (PITR) of bronchial asthma (BA) after intradermal and sublingual-oral allergen-specific immunotherapy (ASIT).
Material and methods. The study included 415 patients of the allergological department of the Vitebsk Regional Clinical Hospital with mixed (allergic and non-allergic) and allergic asthma aged from 18 to 60 years. Patient group 1 (364 patients) was treated with standard pharmacotherapy (PT) and intradermal ASIT with household allergens. Patient group 2 (51 patients) received PT and sublingual-oral ASIT with household allergens. The duration of PITR was estimated. Using ROC-analysis, a predictive model for the occurrence of PITR during 3 years was built for sublingual-oral and intradermal ASIT.
Results. 3-year ASIT courses were enough for the formation of PITR over the next 3 years. According to the ROC analysis, the model for intradermal ASIT is of good quality (a numerical indicator of area under the curve (AUC) = 0.782; p<0.001), the cut-off threshold corresponds to 1 course (sensitivity (Se)=99.5%; specificity (Sp)=75%). The model for sublingual ASIT is of very good quality (AUC=0.8223, p=0.001), cut-off threshold corresponds to 3 courses (Se=84.6%; Sp=73.7%).
Conclusions. ROC-analysis makes it possible to assess the predictive value of PITR models for intradermal and sublingual-oral ASIT, compare them and put them into practice using the cut-off threshold. According to the ROC-analysis, to achieve a 3-year PITR in case of intradermal high-dose ASIT, at least one course was required, for sublingual-oral low-dose ASIT – three courses.
Keywords: bronchial asthma, allergen-specific immunotherapy, postimmunotherapy remission, ROC-analysis.
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Information about authors:
A.V. Sidarenka – senior lecturer of the Chair of General Medical Practice, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-4929-7672
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Alena V. Sidarenka.
